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randomised control trial Emergency medicine

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https://www.readbyqxmd.com/read/29149474/interventions-for-old-world-cutaneous-leishmaniasis
#1
REVIEW
Julio Heras-Mosteiro, Begoña Monge-Maillo, Mariona Pinart, Patricia Lopez Pereira, Emely Garcia-Carrasco, Pedro Campuzano Cuadrado, Ana Royuela, Irene Mendez Roman, Rogelio López-Vélez
BACKGROUND: Cutaneous leishmaniasis, caused by a parasitic infection, is considered one of the most serious skin diseases in many low- and middle-income countries. Old World cutaneous leishmaniasis (OWCL) is caused by species found in Africa, Asia, the Middle East, the Mediterranean, and India. The most commonly prescribed treatments are antimonials, but other drugs have been used with varying success. As OWCL tends to heal spontaneously, it is necessary to justify the use of systemic and topical treatments...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29145878/improving-readiness-for-recruitment-through-simulated-trial-activation-the-adjuvant-steroids-in-adults-with-pandemic-influenza-asap-trial
#2
Wei Shen Lim, Garry Meakin, Clare Brittain, Thomas Bewick, Lelia Duley
BACKGROUND: Research in public health emergencies requires trials to be set up in readiness for activation at short notice and in anticipation of limited timelines for patient recruitment. We conducted a simulated activation of a hibernating pandemic influenza clinical trial in order to test trial processes and to determine the value of such simulation in maintaining trial readiness. METHODS: The simulation involved the Nottingham Clinical Trials Unit, one participating hospital, one manufacturing unit and the Investigational Medicinal Product (IMP) supplier...
November 16, 2017: Trials
https://www.readbyqxmd.com/read/29082016/randomised-controlled-trial-of-two-sequential-artemisinin-based-combination-therapy-regimens-to-treat-uncomplicated-falciparum-malaria-in-african-children-a-protocol-to-investigate-safety-efficacy-and-adherence
#3
Henk Dfh Schallig, Halidou Tinto, Patrick Sawa, Harparkash Kaur, Stephan Duparc, Deus S Ishengoma, Pascal Magnussen, Michael Alifrangis, Colin J Sutherland
BACKGROUND: Management of uncomplicated Plasmodium falciparum malaria relies on artemisinin-based combination therapies (ACTs). These highly effective regimens have contributed to reductions in malaria morbidity and mortality. However, artemisinin resistance in Asia and changing parasite susceptibility to ACT in Africa have now been well documented. Strategies that retain current ACT as efficacious treatments are urgently needed. METHODS: We present an open-label, randomised three-arm clinical trial protocol in three African settings representative of varying malaria epidemiology to investigate whether prolonged ACT-based regimens using currently available formulations can eliminate potentially resistant parasites...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/28985255/haloperidol-versus-placebo-for-delirium-prevention-in-acutely-hospitalised-older-at-risk-patients-a-multi-centre-double-blind-randomised-controlled-clinical-trial
#4
Edmée J M Schrijver, Oscar J de Vries, Peter M van de Ven, Pierre M Bet, Ad M Kamper, Sabine H A Diepeveen, Rob J van Marum, Astrid M van Strien, Sander Anten, Anne M Lagaay, Leo Boelaarts, Frank W Bloemers, Mark H H Kramer, Prabath W B Nanayakkara
Background: because the few randomised placebo-controlled trials investigating the potential role for prophylactic haloperidol in delirium prevention have focused on specific surgical populations, we investigated its efficacy and safety in acutely hospitalised older patients. Methods: this multi-centre, double-blind, stratified, block randomised, placebo-controlled trial was conducted at six Dutch hospitals. Patients age ≥70 years, acutely admitted through the emergency department for general medicine or surgical specialties and at risk for delirium were randomised (n = 245) to haloperidol or placebo 1 mg orally twice-daily (maximum of 14 doses) on top of standard nonpharmacological prevention strategies...
July 15, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28956888/the-9-item-physician-documentation-quality-instrument-pdqi-9-score-is-not-useful-in-evaluating-emr-scribe-note-quality-in-emergency-medicine
#5
Katherine J Walker, Andrew Wang, William Dunlop, Hamish Rodda, Michael Ben-Meir, Margaret Staples
BACKGROUND: Scribes are assisting Emergency Physicians by writing their electronic clinical notes at the bedside during consultations. They increase physician productivity and improve their working conditions. The quality of Emergency scribe notes is unevaluated and important to determine. OBJECTIVE: The primary objective of the study was to determine if the quality of Emergency Department scribe notes was equivalent to physician only notes, using the Physician Documentation Quality Instrument, Nine-item tool (PDQI-9)...
September 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28946920/role-of-bispectral-index-monitoring-and-burst-suppression-in-prognostication-following-out-of-hospital-cardiac-arrest-a-systematic-review-protocol
#6
Leanne Eveson, Marcela Vizcaychipi, Shashank Patil
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is associated with significant mortality or may have a poor neurological outcome. Various community-training programmes have improved practices like bystander cardiopulmonary resuscitation (CPR) and early defibrillation using automated external defibrillator (AED). Post-resuscitation care has also changed significantly in the millennium. Interventions like targeted temperature management (TTM), avoidance of hyperoxia and emergency cardiac catheterisation have given patients a chance of a better neurological outcome...
September 25, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28918414/a-protocol-of-a-cross-sectional-study-evaluating-an-online-tool-for-early-career-peer-reviewers-assessing-reports-of-randomised-controlled-trials
#7
Anthony Chauvin, David Moher, Doug Altman, David L Schriger, Sabina Alam, Sally Hopewell, Daniel R Shanahan, Alessandro Recchioni, Philippe Ravaud, Isabelle Boutron
INTRODUCTION: Systematic reviews evaluating the impact of interventions to improve the quality of peer review for biomedical publications highlighted that interventions were limited and have little impact. This study aims to compare the accuracy of early career peer reviewers who use an innovative online tool to the usual peer reviewer process in evaluating the completeness of reporting and switched primary outcomes in completed reports. METHODS AND ANALYSIS: This is a cross-sectional study of individual two-arm parallel-group randomised controlled trials (RCTs) published in the BioMed Central series medical journals, BMJ, BMJ Open and Annals of Emergency Medicine and indexed with the publication type 'Randomised Controlled Trial'...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28891235/financial-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#8
REVIEW
Charles S Wiysonge, Elizabeth Paulsen, Simon Lewin, Agustín Ciapponi, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Gabriel Rada, Andrew D Oxman
BACKGROUND: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. OBJECTIVES: To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28866621/randomised-controlled-trial-to-assess-the-effect-of-a-just-in-time-training-on-procedural-performance-a-proof-of-concept-study-to-address-procedural-skill-decay
#9
Jeremy B Branzetti, Adeyinka A Adedipe, Matthew J Gittinger, Elizabeth D Rosenman, Sarah Brolliar, Anne K Chipman, James A Grand, Rosemarie Fernandez
BACKGROUND: A subset of high-risk procedures present significant safety threats due to their (1) infrequent occurrence, (2) execution under time constraints and (3) immediate necessity for patient survival. A Just-in-Time (JIT) intervention could provide real-time bedside guidance to improve high-risk procedural performance and address procedural deficits associated with skill decay. OBJECTIVE: To evaluate the impact of a novel JIT intervention on transvenous pacemaker (TVP) placement during a simulated patient event...
November 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28748654/review-article-does-acupuncture-have-a-role-in-providing-analgesia-in-the-emergency-setting-a-systematic-review-and-meta-analysis
#10
REVIEW
Andrew L Jan, Emogene S Aldridge, Ian R Rogers, Eric J Visser, Max K Bulsara, Richard C Niemtzow
Acupuncture might offer a novel approach to improve ED pain management. Our primary aim was to assess the efficacy of acupuncture in the emergency setting while secondary objectives were to explore its suitability through its side-effect profile, patient satisfaction, cost, administration time and points used. Seven databases and Google Scholar were searched up to 31 July 2016 using MeSH descriptors for three overarching themes concerning acupuncture, pain management and emergency medicine. Meta-analysis was performed on randomised trials for three comparator groups: acupuncture versus sham, acupuncture versus standard analgesia care and acupuncture-as-an-adjunct to standard care, to calculate the standardised mean difference and weighted mean difference for pain scores out of 10...
October 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#11
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire O'Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619302/chinese-herbal-medicine-for-treating-menopausal-symptoms-in-london-women-developing-a-good-practice-protocol-via-the-factor-analysis-of-prescribing-patterns-in-a-clinical-study
#12
Volker Scheid, Veronica Tuffrey, Mark Bovey
The objective of the study described in this paper was to define Chinese medicine formula patterns for the treatment of menopausal women in London. These formula patterns are intended to inform the development of best practice guidelines for a future pragmatic randomised controlled trial, with the ultimate goal of evaluating the possibility of integrating Chinese medicine treatment strategies for menopausal symptoms into the UK National Health Service. Data from a clinical study that had demonstrated the effectiveness and safety of Chinese medicine in treating 117 perimenopausal women at the Westminster University Polyclinic in London were analysed for symptom occurrence and herb use...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28450467/quality-of-reporting-in-abstracts-of-rcts-published-in-emergency-medicine-journals-a-protocol-for-a-systematic-survey-of-the-literature
#13
Federico Germini, Maura Marcucci, Marta Fedele, Maria Giulia Galli, Lawrence Mbuagbaw, Valentina Salvatori, Giacomo Veronese, Andrew Worster, Lehana Thabane
INTRODUCTION: The quality of reporting of abstracts of randomised controlled trials (RCTs) in major general medical journals and in some category-specific journals was shown to be poor before the publication of the ConsolidatedStandards of ReportingTrials (CONSORT) extension for abstracts in 2008, and an improvement in the quality of reporting of abstracts was observed after its publication. The effect of the publication of the CONSORT extension for abstracts on the quality of reporting of RCTs in emergency medicine journals has not been studied...
April 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28302636/pharmacist-provided-medicines-reconciliation-within-24%C3%A2-hours-of-admission-and-on-discharge-a-randomised-controlled-pilot-study
#14
Brit Cadman, David Wright, Amanda Bale, Garry Barton, James Desborough, Eman A Hammad, Richard Holland, Helen Howe, Ian Nunney, Lisa Irvine
BACKGROUND: The UK government currently recommends that all patients receive medicines reconciliation (MR) from a member of the pharmacy team within 24 hours of admission and subsequent discharge. The cost-effectiveness of this intervention is unknown. A pilot study to inform the design of a future randomised controlled trial to determine effectiveness and cost-effectiveness of a pharmacist-delivered service was undertaken. METHOD: Patients were recruited 7 days a week from 5 adult medical wards in 1 hospital over a 9 month period and randomised using an automated system to intervention (MR within 24 hours of admission and at discharge) or usual care which may include MR (control)...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28166743/molecular-point-of-care-testing-for-respiratory-viruses-versus-routine-clinical-care-in-adults-with-acute-respiratory-illness-presenting-to-secondary-care-a-pragmatic-randomised-controlled-trial-protocol-respoc
#15
Nathan J Brendish, Ahalya K Malachira, Tristan W Clark
BACKGROUND: Respiratory viruses are associated with a huge socio-economic burden and are responsible for a large proportion of acute respiratory illness in hospitalised adults. Laboratory PCR is accurate but takes at least 24 h to generate a result to clinicians and antigen-based point-of-care tests (POCT) lack sensitivity. Rapid molecular platforms, such as the FilmArray Respiratory Panel, have equivalent diagnostic accuracy to laboratory PCR and can generate a result in 1 h making them deployable as POCT...
February 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#16
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28051764/the-use-of-fibrin-sealant-during-non-emergency-surgery-a-systematic-review-of-evidence-of-benefits-and-harms
#17
Steven J Edwards, Fay Crawford, Michelle Helena van Velthoven, Andrea Berardi, George Osei-Assibey, Mariana Bacelar, Fatima Salih, Victoria Wakefield
BACKGROUND: Fibrin sealants are used in different types of surgery to prevent the accumulation of post-operative fluid (seroma) or blood (haematoma) or to arrest haemorrhage (bleeding). However, there is uncertainty around the benefits and harms of fibrin sealant use. OBJECTIVES: To systematically review the evidence on the benefits and harms of fibrin sealants in non-emergency surgery in adults. DATA SOURCES: Electronic databases [MEDLINE, EMBASE and The Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and the Cochrane Central Register of Controlled Trials)] were searched from inception to May 2015...
December 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28010731/a-survey-of-facilitators-and-barriers-to-recruitment-to-the-magnetic-trial
#18
Geetinder Kaur, Rosalind L Smyth, Colin V E Powell, Paula Williamson
BACKGROUND: Recruitment to randomised controlled trials with children is challenging. It is imperative to understand the factors that boost or hinder recruitment of children to clinical trials. We conducted a survey of facilitators and barriers to recruitment to the MAGNETIC trial, using a previously developed web-based tool. METHODS: MAGNETIC is a multicentre randomised trial of nebulised magnesium in acute severe asthma, recruiting 508 children from 30 UK sites...
December 23, 2016: Trials
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#19
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27855099/cluster-randomised-feasibility-trial-to-improve-the-control-of-hypertension-in-rural-india-chiri-a-study-protocol
#20
Michaela A Riddell, Rohina Joshi, Brian Oldenburg, Clara Chow, K R Thankappan, Ajay Mahal, Nihal Thomas, Velandai K Srikanth, Roger G Evans, Kartik Kalyanram, Kamakshi Kartik, Pallab K Maulik, Simin Arabshahi, R P Varma, Rama K Guggilla, Oduru Suresh, G K Mini, Fabrizio D'Esposito, Thirunavukkarasu Sathish, Mohammed Alim, Amanda G Thrift
INTRODUCTION: Hypertension is emerging in rural populations of India. Barriers to diagnosis and treatment of hypertension may differ regionally according to economic development. Our main objectives are to estimate the prevalence, awareness, treatment and control of hypertension in 3 diverse regions of rural India; identify barriers to diagnosis and treatment in each setting and evaluate the feasibility of a community-based intervention to improve control of hypertension. METHODS AND ANALYSIS: This study includes 4 main activities: (1) assessment of risk factors, quality of life, socioeconomic position and barriers to changes in lifestyle behaviours in ∼14 500 participants; (2) focus group discussions with individuals with hypertension and indepth interviews with healthcare providers, to identify barriers to control of hypertension; (3) use of a medicines-availability survey to determine the availability, affordability and accessibility of medicines and (4) trial of an intervention provided by Accredited Social Health Activists (ASHAs), comprising group-based education and support for individuals with hypertension to self-manage blood pressure...
October 8, 2016: BMJ Open
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